As healthcare costs have risen rapidly in the last decade, employer-sponsored health insurance premiums have followed,1 affecting both organizations and employees. Plan sponsors see continuously rising costs and may question if they’re getting their money’s worth.

Data analytics is the first step in answering that question, directing employers toward what medical situations can sink a healthcare plan. Analytics can show the conditions, treatments, and outcomes that are problematic and need addressing.

But to fully understand any healthcare plan issue — and know how to fix it — requires clinical informatics, where experts examine data from a medical perspective.

The need to improve recruiting and retention has affected employee benefits and workforce absence management rather considerably these past two years, in some cases resulting in more liberal policies on hybrid work, paid time off (PTO) and observed holidays.

HUB International’s 2023 Workforce Absence Management Survey, which surveyed 514 employers with 50 to 1,000 employees, found that remote and hybrid work trends continue, with more companies making these options standard. These same employers are also providing additional paid holidays and PTO.

The survey found that employers are implementing these changes largely to stay competitive in the ongoing battle to attract and keep top talent. And employers say they’re likely to implement more changes in absence management to improve the work environment.

Employers of every size continue to struggle with the rising costs of healthcare, which ultimately increases the cost of medical premiums for everyone.

While employers have traditionally worried about large medical claims, the growing popularity of exorbitantly-priced specialty drugs is creating an entirely new category of potentially catastrophic healthcare spend. 

In fact, after raising the prices of more than 1,400 prescription drugs in 2022, pharmaceutical companies started 2023 off with a 5% increase for more than 450 medications. Add to that considerable pipeline of new medicines to treat specialty diseases, including gene cell therapies, RNA therapies, immuno-oncology treatments, etc., and you have a recipe for disaster.

One solution means looking inward: transitioning from the fully funded model of healthcare benefits to self-funded health plans featuring stop-loss insurance. Stop-loss insurance is essential for a self-funded plan because it enables an employer to cap medical claims expenses at a specific amount. 

The SECURE Act 2.0 contains dozens of changes to retirement plans, but perhaps none bigger than these two: New 401(k) and 403(b) plans will be required to automatically enroll participants in the respective plans, and employee salary deferral rates will automatically escalate each year.

This rule will apply to employers who have started retirement plans after December 29, 2022, and take effect for plan years starting in 2025.

There is an exception for new companies in business for less than three years, employers with 10 or fewer employees, and governmental and church plans.

For plan sponsors, the details include: 

As an employer, it is crucial to consider the diverse needs and preferences of the workforce when designing a Paid Time Off (PTO) program.

We, therefore, thought it might be fitting on our newest federal holiday, Juneteenth, to delve into the topic of selecting holidays for your PTO program, aiming to find a balance that pleases the majority of your workforce.

While advocating for a well-rounded approach, we’ll also make sure to explore the potential challenges and implications that arise when trying to please everyone.  

Similar to Quiet Quitting, Bare Minimum Mondays is a trend entailing employees prioritizing their work-life balance and mental health by doing the least amount of work possible on Mondays in the hopes of avoiding burnout during the rest of the week.

The practice is generally in response to underlying issues, such as lack of engagement and stress. It's essential for employers to understand this trend so they know how to support employees' well-being and, in turn, reap the benefits of a healthy workforce.

Today we’ll explain Bare Minimum Mondays and the reasons behind what’s possibly driving this trend. We’ll also provide guidance on how employers can use this trend as an opportunity to understand and meet employee needs.

On May 16, 2023, the IRS released Revenue Procedure 2023-23 to provide the inflation-adjusted limits for health savings accounts (HSAs) and high deductible health plans (HDHPs) for 2024. The IRS is required to publish these limits by June 1 of each year.

These limits include:

• The maximum HSA contribution limit;
• The minimum deductible amount for HDHPs; and
• The maximum out-of-pocket expense limit for HDHPs
  

Inflation has increased the cost of goods and services for most every employer, while low unemployment rates have pushed-up wage and benefit costs across the country. Restaurants, in particular, have seen their costs across the board soar, impacting already slim margins.

Some businesses have started to provide line-item detail of these additional expenses to customers, typically to help justify price increases or to make a political statement.

While this practice isn’t entirely new (it started to gain prominence ten years ago with the passage of the employer mandate, part of the Affordable Care Act), recent actions in this regard by two Scottsdale Arizona restaurants resulted in a $20,000 fine.

A recent study by the International Foundation of Employee Benefit Plans suggests that 32% of employers offer weight management programs while 45% cover bariatric surgery. This same survey indicates that 22% of U.S. employers are now covering certain prescription drugs for weight loss.

Perhaps this increase in prescription drug coverage is due to advancements in weight loss medications, or the growing recognition that obesity is a disease that increases the risk of other chronic conditions, such as high blood pressure, type 2 diabetes, coronary heart disease, and some cancers.

After all, the costs of obesity are enormous: Up to half of new diabetes cases in the U.S. are linked to obesity, and obesity costs the healthcare system nearly $173 billion annually.

Nevertheless, these drugs are expensive, costing as much as $1,400 a month, and necessitate long-term dosing.  And it’s fair to say that some of these drugs are being misused and abused.

This raises the question of whether employer health plan sponsors should cover this new class of drugs to treat obesity.

Despite originally announcing that both the COVID Public Health Emergency and National Emergency would end on May 11, President Biden has signed a resolution ending the National Emergency effective as of April 10, 2023.

Plan sponsors will now have less time to react to the end of the National Emergency, but this does not mean that all COVID coverage mandates or extensions have ended.

What Is Ending?
The end of the National Emergency brings the end of the “Outbreak Period” which gives additional time for individuals to:

• elect and pay for COBRA,
• exercise HIPAA Special Enrollment Rights to change plan elections mid-year, and
• file claims and request appeals of adverse claim decisions under ERISA.

In today's blog post we'll address what's ending, what's not ending, and what plan sponsors need to now do.